A urethral catheter is a flexible plastic or latex tube which is inserted into the bladder via the urethra to drain urine, or instil medications into the bladder. When selecting the type of catheter, do so considering the reason for insertion, and the intended duration required. The aim to use the smallest size which will allow free urinary drainage between size 12 – 16 for males. Larger sizes may be required if there is debris or blood clots, which may block a smaller diameter catheter. Ensure you use the correct length of catheter; the standard length for a male catheter is 40-44cm. Female catheters are shorter, as the female urethra is shorter. If a catheter that is too short is inserted into a male, when the balloon is inflated, it may cause trauma in the urethra. When inserting a urethral catheter, it is important to maintain an aseptic technique, in order to reduce the risk of introducing infection into the urinary tract. In this film, due to the sensitive nature, this procedure will be performed on a catheterisation simulator model.<\/p>\r\n
Once you have watched this video, why not attempt the multiple choice quiz to test your knowledge?<\/p>\r\n
<\/p>","protected":false},"excerpt":{"rendered":"
A urethral catheter is a flexible plastic or latex tube which is inserted into the bladder via the urethra to drain urine, or instil medications into the bladder. When selecting the type of catheter, do so considering the reason for insertion, and the intended duration required. The aim to use the smallest size which will […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2,1],"tags":[],"class_list":["post-64","post","type-post","status-publish","format-standard","hentry","category-tomorrows-clinicians","category-uncategorized","entry"],"youtubeVideo":"509807928\/31284a9543","question1":"Regarding catheter size used in male catheterisation...","answers1":" Male and female catheters are the same size\r\n| In most cases a catheter size of 8-12 is appropriate\r\n| In most cases a catheter size of 12-16 is appropriate\r\n| In most cases a catheter size of 14-20 is appropriate\r\n","correctAnswer1":"2","correctAnswerText1":"A larger catheter lumen may be needed when debris or clots are present.","question2":"Regarding the standard length of catheter used in male catheterisation...","answers2":"A short catheter should be used in order to avoid trauma to the urethra\r\n| A catheter length of 15-20cm is appropriate\r\n| A catheter length of 40-44cm is appropriate in most cases\r\n| The male urethra is approximately 15cm long so the catheter needs to be 15cm in length","correctAnswer2":"2","correctAnswerText2":"Females have much shorter urethras than males. Male patients require a catheter that is longer than the length of the average male urethra (20cm). This is to ensure that urethral trauma is avoided when inflating the balloon.","question3":"Patients should be questioned before the procedure to ascertain allergies, specifically allergies to the following combination of agents...","answers3":"Latex, chlorhexidine and lignocaine.\r\n| Silicon, saline and lignocaine.\r\n| Silicon, chlorhexidine and lignocaine.\r\n| Latex, silicon and chlorhexidine.","correctAnswerText3":"","correctAnswer3":"0","question4":"Skin preparation prior to catheterisation in a ward environment is usually with the following agent:","answers4":" Betadine\r\n| Chlorhexidine\r\n| Saline\r\n| Alcohol","correctAnswer4":"2","correctAnswerText4":"Chlorhexidine and alcohol could cause significant discomfort to the patient, as the urethral mucous membrane will be exposed to the skin preparation agent.","question5":"The lubricating material that should be used contains the following:","answers5":"Chlorhexidine gel\r\n| Lignocaine and chlorhexidine\r\n| Aquagel\r\n| Aquagel and chlorhexidine","correctAnswer5":"1","correctAnswerText5":"","question6":"The lubricating gel should be left to work insitu for approximately how long before the procedure continues?","answers6":" 20 minutes\r\n| 5 minutes\r\n| 1-2 minutes\r\n| Up to 1 minute","correctAnswer6":"1","correctAnswerText6":"This is to allow the local anaesthetic properties within the lignocaine component of the gel to become effective.","question7":"Regarding glove changing during the procedure of male catheterisation:","answers7":"One pair of sterile gloves is necessary for the procedure\r\n| Sterile gloves should be changed to a second pair after the lignocaine has been instilled\r\n| Sterile gloves should be changed to a second pair after inserting the catheter but before connecting the catheter to the drainage bag\r\n| Sterile gloves are not necessary for the procedure of male catheterisation as it is a procedure that takes place in a contaminated body area","correctAnswer7":"1","correctAnswerText7":"Gloves should be changed directly before handling the catheter near its tip. This should be undertaken after the lignocaine gel has been instilled.","question8":"Whilst inserting the catheter...","answers8":"If urine is observed flowing from the catheter before the catheter has been fully inserted, it is safest to stop advancing and inflate the catheter balloon.\r\n| If urine is observed flowing from the catheter before the catheter has been fully inserted, it is safest to continue to insert the catheter to the bifurcation then inflate the balloon.\r\n| If there is any resistance on passing the catheter, it is best to immediately withdraw and attempt to insert a smaller catheter.\r\n| If there is resistance to on passing the catheter it means that the urethra has definitely been damaged.","correctAnswer8":"1","correctAnswerText8":"The catheter should be fully inserted before inflating the balloon to avoid risk of damage to the urethra. The most common (and expected) reason for resistance to the catheter being passed is because it encounters the resistance of the prostate gland. If this occurs, you can ask the patient to take deep breaths to help them relax.","question9":"Regarding inflation of the catheter balloon:","answers9":"The balloon should be inflated slowly with 10ml of sterile water.\r\n| The balloon should be inflated quickly with 10ml of sterile water to obtain a good seal and prevent leakage of urine.\r\n| The balloon should be inflated as soon as urine is seen flowing from the catheter.\r\n| The balloon should be inflated irrespective of resistance to inflation if urine is observed flowing from the catheter.","correctAnswer9":"0","correctAnswerText9":"Insufflation should be slow as any resistance needs to be detected and the procedure stopped before trauma to the urethra or bladder neck occurs.","question10":"It is important to perform the following steps at the end of the procedure : ","answers10":" Reposition the foreskin and tug on the catheter to ensure it is well positioned then ensure the patient is comfortable.\r\n| Reposition the foreskin and document the procedure after making the patient comfortable.\r\n| Reposition the foreskin and remove sterile gloves before connecting the catheter to the drainage bag.\r\n| Remove sterile gloves and connect the catheter to the drainage bag before repositioning the foreskin.","correctAnswer10":"1","correctAnswerText10":"The catheter should only be allowed to move under the influence of gravity after it has been inserted and secured with balloon inflation. Sterile gloves should continue to be worn until the catheter has been connected to the drainage bag.","question11":"The following information regarding the catheter should be documented in the notes after the procedure:","answers11":"Type, size and lot number.\r\n| Length, manufacturing company and date of expiration.\r\n| Date of production and date of expiration.\r\n| Type, size and date of expiration.","correctAnswer11":"0","correctAnswerText11":"Also, regarding the catheter \u2013 document date and time of insertion, volume\/substance used to insufflate balloon, difficulties encountered, residual volume into catheter, frequency of urine output monitoring and instructions regarding removal of catheter.","question12":"For a patient with frank haematuria and clots:","answers12":"A 3 way catheter is useful chiefly because it has a wide lumen.\r\n| A 3 way catheter is useful chiefly because it is rigid and more likely to be inserted successfully.\r\n| A 3 way catheter is useful chiefly because it can be used to irrigate the bladder to remove the clots which may block a Foley catheter.\r\n| A 3 way catheter is useful because it is translucent and the person inserting it can visualise what they are doing more clearly when inserting it.","correctAnswer12":"2","correctAnswerText12":"","question13":"","answers13":"","correctAnswer13":"","correctAnswerText13":"","question14":"","answers14":"","correctAnswer14":"","correctAnswerText14":"","question15":"","answers15":"","correctAnswer15":"","correctAnswerText15":"","icon":"male-urinary-catheterisation","parentId":"","recapId":"403","_links":{"self":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/64"}],"collection":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=64"}],"version-history":[{"count":9,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/64\/revisions"}],"predecessor-version":[{"id":830,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=\/wp\/v2\/posts\/64\/revisions\/830"}],"wp:attachment":[{"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=64"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=64"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vapp.rguc.co.uk\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=64"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}